Shoulder Dystocia

Shoulder dystocia is a complication of vaginal delivery in approximately 0.5% of births. It occurs when the shoulders get stuck in the birth canal and require significant manipulation. Quite often, doctors and midwives will try non-surgical measures to deliver a baby experiencing shoulder dystocia before proceeding to an emergency caesarean section.

Shoulder dystocia is a regarded as a medical emergency. The shoulders need to be urgently released so the baby can be delivered and begin breathing. The complication can cause injury to both mother and baby.

Injuries to mothers include:

• vaginal tears, which may extend to the rectum (third or fourth degree tear)
• injury to the vaginal wall (vaginal laceration)
• heavy bleeding (postpartum haemorrhage)
• emotional trauma

Injuries to babies include:

• brachial plexus injuries – when the nerves in the neck which provide movement and feeling to the arm become stretched. 10% of babies who have shoulder dystocia suffer brachial plexus injuries. This injury can result in temporary and sometimes permanent paralysis of the baby’s arm
• fractures of baby’s arm or shoulder with associated complications
• brain damage or death (rare) if the baby does not get enough oxygen